Six Legionnaires' disease cases tied to Lehigh County outpatient center

State health officials have asked doctors to take a closer look at anyone who developed pneumonia-like symptoms after visiting a South Whitehall Township outpatient facility after a half-dozen cases of Legionnaires' disease were linked to the site.

Integrated Health Campus, at 240 and 250 Cetronia Road, houses a number of offices. In an advisory issued to health care facilities, the Pennsylvania Department of Health asked clinicians to be vigilant for signs of the disease, also called legionellosis, among patients who visited the campus in the 14 days before their illness.

According to a statement from Integrated Health Campus, the investigation has focused on the 250 building, specifically the decorative fountain in its lobby. The company hired Legionella Risk Management Inc. of Chalfont, Bucks County, to conduct an investigation and remediation of the campus water systems after being notified of the risk by the health department Oct. 23.

Kenneth Szydlow, vice president of marketing and public relations for St. Luke's University Health Network, said the 240 building — which contains a number of St. Luke's offices, including cancer treatment — is no longer implicated in the alert.

Dr. Jeffrey Jahre, St. Luke's infectious disease specialist, said all six cases were linked to the 250 building. He said the health department had cleared the campus to continue business as usual. It would not have done so if it had believed staff and visitors were at risk.

"This did not reach that kind of level," Jahre said.

In an email, health department press secretary Aimee Tysarczyk said the department was limited in the information it could share because of restrictions under the Disease Prevention and Control Law regarding continuing investigations.

Regarding the status of the 240 building, Tysarczyk wrote: "The entire campus is currently open; however, we're early in the investigation stages and therefore would not make immediate exclusions."

She encouraged people with concerns to consult a doctor.

"It's important for the public to know that Legionella is commonly found in various places in the environment and cases occur all the time throughout the state," Tysarczyk wrote.

"Legionnaire's is a reportable disease in Pennsylvania, which means health care facilities, health care practitioners and clinical laboratories are required to report it to the Department of Health within 24 hours and thereafter we will investigate those reports, which involves asking a series of questions, including where the individual has recently been."

Finding a location common to patients does not necessarily mean the location is the source of the disease, so the department has to expand its inquiry beyond that common denominator.

Tysarczyk said IHC had been cooperative and followed appropriate measures to assist with the investigation, and that the health department had followed traditional protocols by issuing an advisory — one step below an alert, which indicates a more serious situation — to health care professionals.

The advisory urges vigilance about reporting potential cases so the department can follow up and investigate, Tysarczyk wrote.

IHC's statement said the fountain in the lobby of the 250 building and a fountain outside the lobby were shut down and drained. The results of tests on the water are pending. The facility's drinking water system was also sanitized, though it was not considered a likely source of the infection.

The health department conducted its own inspection, taking water samples Friday.

"According to the Department of Health, in light of the rapid and extensive remediation, it is acceptable to continue business as usual at Integrated Health Campus," the IHC statement said.

Legionnaires' disease, identified in 1976 after a large and deadly outbreak at an American Legion convention in a Philadelphia hotel, is caused by a type of bacteria called Legionella.

Because the 1976 outbreak infected more than 200 people and killed 34, the disease developed a fearsome reputation. But Jahre said the illness is no longer a mystery and reports of it should not breed undue anxiety.

"It's not an uncommon bacteria found in the environment," he said. "It's not even an uncommon pneumonia, frankly. As we've been able to identify it more readily, we identify it more often."

Legionella bacteria are found naturally, mainly in water. Likely sites for colonization include hot tubs, hot water tanks, large plumbing systems, cooling towers and decorative fountains. The 1976 outbreak was traced to the cooling tower of the hotel's air conditioning system.

People get the disease when they breathe in mist or vapor containing the bacteria. Most people exposed to the bacteria don't get sick, and those who do typically recover with antibiotic treatment. The disease is not spread from person to person.